Opportunities for optimizing therapy in the metabolic phenotype of osteoarthritis

Osteoarthritis (OA) is an extremely heterogeneous disease. Identifying a specific disease phenotype will help the practitioner optimize approaches to diagnosis and treatment. The metabolic phenotype of OA is associated with the greatest polyand comorbidity, which will significantly limit the choice of a number of drugs often used in the treatment of this joint pathology. The presented clinical observation demonstrates the difficulties in the care of a patient with a combination of eleven somatic diseases at the same time, one of which was OA. Care tactics suggest, on the one hand, justified polypragmasy, on the other hand, low adherence to long–term use of a large number of drugs. The presence of many comorbid diseases, in particular coronary heart disease, and history of stroke, suggest a complete rejection of the use of nonsteroidal anti-inflammatory drugs (with the exception of local forms). Regular therapy with a bioactive extract from small marine fish in the last two years has made it possible to achieve clinical improvement and, probably, prevent radiographic progression of knee joint OA and delay joint replacement surgery.